ARDIOVASCULAR DISEASE (CVD) remains the most common cause of death in industrialized countries, and hypertension is themostfrequenttreatableriskfactor.The analysis of international variation in risk factors has historically resulted in important insights into the etiology of CVD. 1 Moreover,internationalcomparisonsprovide useful information about achievable levels of risk reduction. Most etiologic research studies 1,2 on geographic variation in hypertension have investigated specific hypotheses, such as the role of fat or salt consumption, often choosing extreme social environments to maximize contrasts. Other projects, most notably the World Health Organization Monitoring of Trends and Determinants in Cardiovascular Disease (WHO MONICA) Project, sought to characterize overall coronary risk profiles and monitor trends. 3,4 In recent years, many countries have undertaken large-scale national health surveys that include rigorous measurement of cardiovascular risk status. Considerable epidemiologic research has been conducted using these surveys, such as the US National Health and Nutrition Examination Surveys (NHANES). 5,6 When measurements are Author Affiliations and Financial Disclosure are listed at the end of this article.

Compared with current US references, the proposed German BP reference values are not influenced by the prevalence of overweight children in the reference population, they are based on a validated oscillometric device, and they take advantage of improved statistical methods.

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The current study provides new insight into regulation and diagnostic value of BNP in middle-aged subjects and demonstrates important independent effects of LV function and mass upon BNP plasma concentrations. Although measurement of BNP cannot be recommended for the detection of marginally impaired LV function in the population, it may be helpful to suggest or exclude severe LV dysfunction with concomitant hypertrophy.